乳腺黏液癌的MRI诊断

目的探讨乳腺黏液癌在MRI上的影像表现特点及诊断要点。材料与方法搜集2013-2015年我院15例术前接受乳腺MR检査并经手术病理证实的乳腺黏液癌患者,对其MR图像进行回顾性分析,包括:病变位置、大小、形态,平扫时TIW1、T2WI及抑脂序列信号强度,增强后肿块强化方式及动态增强曲线类型,DWI表现及ADC值测定,并结合术前乳腺影像报告和数据系统(BI-RADS)MRI的影像诊断结果进行分析。结果15例乳腺黏液癌(12例单纯型、3例混合型,4例术后示腋窝淋巴结转移)发生于左乳者8例(53.3%),右乳者7例(46.7%);位于中央前部者1例(6.7%),余丨4例(93.3%)均位于外周偏上、偏内侧区域,其中位于中部者10例(66.7%)、后部者4例(26.6%);均表现为肿块,最大径7?45 mm不等,其中8例(53.3%)呈类圆形,边界清晰光整或伴浅分叶,7例(46.7%)形态欠规则,边缘局部模糊、毛糙或伴毛刺;平扫T1WI呈等或稍低信号,T2WI及脂肪抑制序列上均呈高或明显高信号;动态增强后,9例(60%)以增强早期肿块边缘明显环形強化伴肿块内向心性渗透样强化为主,6例(40%)以肿块内不均匀強化为主;TIC除1例(6.7%)为平台型,佘14例(93.3%)均为上升型。DWI上全部或局部区域呈明显高信号,平均ADC值mm~2/s时为(2.0S±0.44)×10~(-3)mm~2/s,高于正常乳腺组织(1.45±0.56)×10~(-3)mm~2/s。结论乳腺黏液癌的MRI表现具有一定的特征性,术前MRI检查有助提高影像诊断的准确性、并对预后有提示价值。

The MRI diagnosis of mucinous breast carcinoma

Objective:To analyze MRI features and diagnostic essentials of mucinous breast carcinoma (MBC).Materials and Methods:MRI characteristics of 15 MBC patients confirmed by postoperative pathology were analyzed retrospectively, including the lesions' location, size, shape, and the signal intensity on T1WI, T2WI, T2WI-FS, and the enhancement features and time-signal intensity curve (TIC) types, and DWI, ADC value. The preoperative breast MRI BI-RADS reports were reviewed as well.Results:Fifteen patients (12 cases of simplex type, 3 cases of mixed type, 4 cases with lymph node metastasis) occurred in left breast in 8 cases (53.3%) and right breast in 7 cases (46.7%). One case (6.7%) located in the central front, another 14 cases (93.3%) located in the peripheral upper or inner area, which was located in the central in 10 cases (66.7%), and the back in 4 cases (26.6%). MRI showed a mass in all the patients, which diameters were 7—45 mm, of which 8 cases (53.3%) showed round, clear boundary or with light lealfets, 7 cases (46.7%) showed irregular shapes, local fuzzy or coarse edge, even combined with burr. On T1WI, all showed iso-or slightly hypo-intensity. On T2WI and SPAIR, all showed hyper-or obvious hyper- intensity. Dynamic enhanced, 9 cases (60%) showed early rim enhancement, and then permeated into the mass, 6 cases (40%) showed heterogeneous enhancement. The TIC curves of 14 cases (93.3%) were gradually enhancing pattern, and just 1 case (6.7%) was plateau pattern. On DWI, there were obviously hyper-intensity in full or partial area, the average ADC value was (2.08±0.44)× 10-3 mm2/s when b-value was 800 s/mm2, which was higher than normal breast tissue (1.45±0.56)×10-3 mm2/s .Conclusions:The MRI characteristics of MBC are helpful for the preoperative imaging diagnosis and the prognosis prediction.